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Biomedical subjects

R J Hunt

Publications and source records attributed to R J Hunt.

At least 19 recordsLinked to original sources
PubMed2004

Surgical repair of rib fractures in 14 neonatal foals: case selection, surgical technique and results.

REASONS FOR PERFORMING STUDY: Fractured ribs are encountered quite frequently in newborn Thoroughbred foals, often with fatal outcome. Surgical repair of fractures therefore requires consideration as a means of reducing mortality. OBJECTIVES: To evaluate the repair of rib fractures using internal fixation techniques in foals at 2 different equine hospitals following similar diagnostics and case selection. METHODS: The records of 14 foals that underwent internal fixation of fracture ribs were reviewed. Subject details, clinical presentation, diagnosis, surgical technique, post operative care and complications were recorded. Follow-up information was obtained in 7 foals. RESULTS: The fractured ribs were reduced and stabilised using reconstruction plate(s), self-tapping cortical screws and cerclage wire in 12 cases, Steinmann pins and cerclage wires in 1 case and both techniques in 1 case. Not every rib was reduced on each case. Surgical reduction was performed on an average of 2 ribs, range 1-3 ribs in each foal. At the time of writing, 4 foals had been sold, one age 2 years was in training and 2 others died from unrelated causes. CONCLUSIONS: Our data support the use of surgical stabilisation utilising reconstruction plates, self-tapping cortical screws and cerclage wire for selected cases of thoracic trauma in neonatal foals. The use of Steinmann pins may be suboptimal due to cyclic failure, implant migration and the potential for iatrogenic internal thoracic trauma. POTENTIAL RELEVANCE: Foals with existing extensive internal thoracic trauma resulting from rib fracture(s), or the potential for such trauma, previously considered to have a guarded to poor prognosis for survival, may be successfully managed with internal fixation of selected fracture sites.

Animals↗
PubMed2001

Scedosporium prolificans infection associated with arthritis and osteomyelitis in a horse.

Scedosporium prolificans was associated with arthritis and degenerative osteomyelitis in a 6-year-old Thoroughbred racehorse. The horse was suspected to have an inflammatory lesion of the interosseous tendon, but treatment had resulted in only a minimal response. Shortly after diagnostic arthrocentesis of the left metacarpophalangeal joint was performed, the joint became severely swollen, and radiography of the area revealed lysis of the distal end of the third metacarpal bone, the proximal sesamoid bones, and the proximal end of the proximal phalanx. The horse did not respond to treatment and was euthanatized. At necropsy, severe erosive arthritis and degenerative osteomyelitis of the left metacarpophalangeal joint were seen. Swab specimens of the ulcerated lesions of the articular cartilage were submitted for microbial culture, and Scedosporium prolificans was isolated. Scedosporium prolificans is a newly recognized opportunistic fungal pathogen of humans and animals. In humans, S prolificans typically causes focal locally invasive infections that primarily involve musculoskeletal tissues; most often, infection is a result of penetrating trauma or surgical incision. In immunocompromised patients, fatal disseminated infection can occur. The fungus is resistant to almost all currently available antimycotic agents.

Animals↗
PubMed2000

Career satisfaction and job characteristics of dental hygiene master's degree graduates.

PURPOSE: The primary objectives of this study were to assess career and degree satisfaction as well as job characteristics of individuals graduating from programs awarding the master of science in dental hygiene or dental hygiene education degree. METHODS: A pilot-tested questionnaire was mailed to all 252 individuals who graduated between 1980 and 1995 from eight dental hygiene master's degree programs (MSDH). The questionnaire included both closed- and open-ended items regarding career history/career path, career satisfaction, professional involvement, and opinions/perceptions about the graduate program the participant attended. Responses were analyzed using descriptive statistics and two-way tables. RESULTS: After three complete mailings, the response rate was 69% (n = 174). The majority of respondents reported currently working approximately five days per week (54%), with 62% having annual salaries over $40,000. Eighty-six percent were satisfied overall with their career choices, although 30% stated that they would not pursue the same degree again. CONCLUSION: Overall, graduates from MSDH programs are satisfied with their degree choice as well as the opportunities it has afforded them. These findings serve to expand the knowledge base of graduate dental hygiene education and of the graduates from these programs as well as provide suggestions for improvement to graduate dental hygiene programs.

Attitude of Health Personnel↗
PubMed1996

Salivary flow and risk of tooth loss in an elderly population.

To investigate the relationship between salivary flow and tooth loss, 818 randomly selected dentate people aged 65 and older and living in North Carolina were administered a dental health interview and examination. A single paraffin-stimulated whole saliva sample of 3 ml was collected and flow rate was calculated. Three years later, 490 people were re-examined and tooth loss was determined. Thirty-five percent of the participants had salivary flow rates of 1.0 ml/min or less at baseline and 41% lost at least one tooth over the 3-yr follow-up. A logistic regression model controlling for marital status, race, and socioeconomic status showed that those with low salivary flow were more likely to lose at least one tooth during the 3-yr study period than were those with normal flow (odds ratio = 1.52, 95% CI = 1.02-2.24). Results from this representative study of community-dwelling older adults support the concept that compromised salivary flow is related to tooth loss. This finding should be considered in the management and prevention of oral diseases.

Age Factors↗
PubMed1996

Adjustment of the M-component of the DMFS index for prevalence studies of older adults.

Cross-sectional studies of caries in older adults report a substantial number of missing teeth, making it difficult to estimate caries experience accurately. The goal of this study was to improve the method of estimating caries experience as expressed by the DMFS index in population groups with missing teeth. The adjustment was demonstrated with reference to the Piedmont 65+ Dental Study conducted on a random sample of 363 community-dwelling older adults in North Carolina who were followed for 5 years. These older dentate adults had a mean (+/-SE) of 11.7 +/- 0.5 teeth missing at baseline, 56.1 +/- 2.5 missing surfaces and a DMFS of 86.7 +/- 2.0. A predicted caries prevalence was determined from the DFS at 5 yrs plus the 5-yr DFS incidence and the baseline DFS of teeth lost during the study period. Then a formula was developed that would estimate the predicted caries prevalence as a function of the observed 5-yr DMFS. This formula provided a good estimation of caries prevalence at 5 yrs (DMFSadj) when compared with the predicted prevalence (paired t-test, p > 0.05), while prevalence was underestimated by the DFS and greatly overestimated by the traditional DMFS index. Subgroup analyses by race, sex, and periodontal status also indicated that the DMFSadj resulted in patterns of estimates similar to the predicted prevalence, while the DFS and the DMFS were likely to result in different findings. The DMFS from the time of tooth eruption also was adjusted using this formula. The resulting analyses of subgroup differences in caries were not different from the previous estimates based on the 5-yr historical data, indicating that the adjustment of all M surfaces avoids the biases inherent in the traditional DMFS and DFS indices. This study showed that predicted caries prevalence could be estimated by adjusting the M component of the DMFS. It appears that this adjustment formula can be used without obvious bias, but additional studies are needed to provide adjustment figures for populations with different caries prevalences.

Black or African American↗
PubMed1996

Five-year incidence rates and intraoral distribution of root caries among community-dwelling older adults.

The 5-year incidence and intraoral distribution of decayed and filled root surfaces were evaluated in 379 black and 323 white residents of North Carolina aged 65 and older. During the period of study, approximately 39% of blacks developed at least one root DFS compared with 52% for whites (Wald X(2) test, p = 0.062). When the results were calculated using the net root DFS increment, blacks did not have significantly higher rates than whites over the 5-year study period (0.52 surfaces/person versus 0.42 surfaces/person, Survey Regression, n = 363, p = 0.708). However, for blacks, the 5-year incidence density rate of root DFS was 0.26 per 60 surface-months at risk, and for whites the rate was 0.19 new root DFS per 60 surface-months (incidence density ratio = 1.33, 95% CI = 1.01-1.76, p = 0.047). Intraoral distribution patterns for root caries incidence revealed that the approximal surfaces of the anterior teeth were involved most frequently, particularly in the mandible and maxilla in whites, followed in decreasing order by the buccal surfaces of the lower anteriors and the mesial surfaces of the upper anteriors in blacks. Although root caries incidence rates were obviously low, there were significant differences in the occurrence of caries between blacks and whites. The pattern of occurrence was similar for both races with root surface disease being concentrated in the approximal surfaces of the anterior teeth in a small proportion of affected individuals, with whites presenting more filled root increments than blacks. These findings suggest a need for more caries treatment in blacks and increased monitoring of this population since they are at a higher risk for root caries.

Black or African American↗
PubMed1996

Variations in the social impact of oral conditions among older adults in South Australia, Ontario, and North Carolina.

Previous studies among older adults have demonstrated that oral disease frequently leads to dysfunction, discomfort, and disability. This study aimed to assess variations in the social impact of oral conditions among six strata of people aged 65 years and older: residents of metropolitan Adelaide and rural Mt Gambier, South Australia; residents of metropolitan Toronto-North York and non-metropolitan Simcoe-Sudbury counties, Ontario, Canada; and blacks and whites in the Piedmont region of North Carolina (NC), United States. Subjects were participants in three oral epidemiological studies of random samples of the elderly populations in the six strata. Some 1,642 participants completed a 49-item Oral Health Impact Profile (OHIP) questionnaire which asked about impacts caused by problems with the teeth, mouth, or dentures during the previous 12 months. The percentage of dentate people reporting impacts fairly often or very often was greatest among NC blacks for 41 of the OHIP items. Two summary variables of social impact were used as dependent variables in bivariate and multivariate least-squares regression analyses. Among dentate people, mean levels of social impact were greatest for NC blacks and lowest for NC whites, while people from South Australia and Ontario had intermediate levels of social impact (P < 0.01). Missing teeth, retained root fragments, root-surface decay, periodontal pockets, and problem-motivated dental visits were associated with higher levels of social impact (P < 0.05), although there persisted a two-fold difference in social impact across the six strata after adjustment for those factors Among edentulous people, there was no statistically significant variation in social impact among strata. The findings suggest that there are social and cultural factors influencing oral health and its social impact, and that those factors differ most between dentate blacks and whites in NC.

Black or African American↗
PubMed1995

Unilateral choanal atresia in a foal.

A 4-month-old Thoroughbred foal was examined because of a history of exercise intolerance and lack of airflow from the right nostril since birth. Endoscopy of the airways revealed complete membranous obstruction of the right nasal passage at the level of the nasopharynx and marked narrowing of the caudal aspect of the right ventral meatus. Unilateral choanal atresia was diagnosed. Laser ablation of the obstructing tissues was attempted through a videoendoscope. Scar tissue occluded the right nasal passage at follow-up examination 7 weeks later. Intranasal resection, using laparoscopic instruments, was then performed, and a nasal stent was maintained for 2 weeks after surgery. At 1 year of age, the foal was reported to have decreased airflow from the right nares and excessive respiratory noise during exercise. Atresia of the choanae in horses usually is bilateral and, therefore, life-threatening and detectable at birth. Unilateral choanal atresia may not be suspected until later, but should be considered in horses with decreased or no airflow from 1 naris.

Airway Obstruction↗
PubMed1995

Physicochemical properties, pharmacokinetics, and biodistribution of gadoteridol injection in rats and dogs.

RATIONALE AND OBJECTIVES: The physicochemical properties of gadoteridol, a macrocyclic nonionic gadolinium complex, were studied together with its pharmacokinetics and biodistribution in rats and dogs. METHODS: Studies in rats were conducted after single intravenous injections at 0.1 or 0.35 mmol/kg using 153Gd-labeled gadoteridol or with seven daily doses of 0.1 mmol/kg to examine the levels of residual gadolinium in organs. Nonradioactive biodistribution and excretion studies were performed in dogs following injection at 0.1 mmol/kg. RESULTS: After injection, the dose was rapidly cleared from rat blood and excreted such that more than 90% of the dose appeared in the urine within 4 hr of injection. At 7 and 14 days postinjection, only extremely low levels of gadolinium were observed in liver and bone; these levels were two to eight times lower than the levels reported after the injection of gadopentetate dimeglumine. CONCLUSION: The extracellular distribution and rapid urinary excretion of gadoteridol is in agreement with data obtained with other gadolinium-containing chelates used as intravascular magnetic resonance imaging contrast agents. Differences observed in the long-term retention of gadolinium between gadoteridol and gadopentetate dimeglumine were consistent with the reported greater in vivo resistance to transmetallation of gadolinium macrocycles compared with the linear gadolinium chelate molecules.

Animals↗
PubMed1995

Three-year root caries incidence and risk modeling in older adults in North Carolina.

OBJECTIVES: The purposes of this study were to describe the incidence of root caries and to identify its risk factors in a representative sample of older adults. METHODS: Root caries incidence was estimated and multivariate risk assessment models were developed to identify predictors for root caries in a three-year follow-up study of 234 black and 218 white noninstitutionalized adults aged 65 and older residing in North Carolina. RESULTS: During the observation period, 29 percent of blacks developed root caries, compared to 39 percent of whites (P < .05). The mean net DFS increment per person was 0.55 +/- 0.13 root surfaces for blacks vs 0.80 +/- 0.21 for whites (P > .32). Multivariate logistic regression analysis indicated that blacks wearing a partial denture, having some root fragments, having an average gingival recession > or = 2 mm, and being free of P. intermedia were at greater risk for developing new root caries. The model for whites showed that retired people with their most severe gingival recession > or = 4 mm, an average probing pocket depth > or = 2 mm, and taking antihistamines were more likely to develop new lesions. CONCLUSIONS: These findings suggest that older blacks had less risk of root caries than whites, and in both groups indicators of poor periodontal status increased the risk of root caries.

Aged↗
PubMed1995

Risk factors for dental fluorosis in pediatric dental patients.

OBJECTIVES: Concerns have been raised recently about whether a substantial amount of dental fluorosis is resulting from the increased use of fluoride from various sources. The purposes of this study were to determine the prevalence and severity of dental fluorosis in a sample of pediatric patients seeking dental treatment in a university pediatric dental clinic and to evaluate sources of fluoride as risk factors for dental fluorosis. METHODS: A convenience sample of 157 children aged 8 to 17 years were examined for dental fluorosis using the Tooth Surface Index of Fluorosis (TSIF). Fluoride history questionnaires assessing previous exposure to fluoride during the first eight years of life were completed by the children's parents. Fluoride exposures were compared among 54 cases and 54 matched controls using a case-control retrospective design. RESULTS: Fluorosis was found in 72 percent of the children, but was generally quite mild. The risk of fluorosis was significantly greater for children who had greater exposure to fluoridated water and who used larger amounts of fluoridated toothpaste up to age eight. CONCLUSIONS: This study provided evidence that increased use of fluoride toothpaste may be a risk factor for dental fluorosis. The results suggest prudent use of dentifrice by young children to minimize the risk of fluorosis.

Adolescent↗
PubMed1995

Differences between racial groups in the impact of oral disorders among older adults in North Carolina.

OBJECTIVES: This study investigated variations in impact of oral disorders between older black adults and older white adults living in North Carolina. METHODS: Using the Oral Health Impact Profile (OHIP) questionnaire, 440 participants aged 70 and older provided data on their perceptions of the impact of oral disease on aspects of their lives during the previous 12 months. RESULTS: For 22 of the 49 items queried in the OHIP questionnaire, older blacks reported more frequent impact than older whites (P < .05). For none of the OHIP items did whites report more frequent impact. The impacts reported were diverse and included items reflecting pain, physical disability, psychological disability, and social disability. When the number of items occurring fairly often or very often were summed for dentate participants, blacks reported more items than did whites (3.7 vs 1.1, P < .0001). This difference decreased to 2.7 vs 2.0 (P < .346) after controlling statistically for greater mean periodontal pocket depth, more unreplaced missing teeth, and more episodic dental visits among blacks. CONCLUSIONS: Older dentate blacks reported more impact from oral problems than older dentate whites. The differences in reported impact likely are linked to differences in oral status and dental visit history between these two racial groups in North Carolina.

Black or African American↗
PubMed1995

Three-year tooth loss among black and white older adults in North Carolina.

The distribution and determinants of tooth loss in older adults are poorly defined, especially in Blacks, who have been underrepresented in previous studies. This study investigated, epidemiologically, the distribution and predictors of tooth loss in elder Blacks and Whites by following a random sample of older adults in North Carolina for three years. It was hypothesized that Blacks would be at greater risk of tooth loss and would have different risk factors for tooth loss. Data from 263 Blacks and 228 Whites were collected by dental examinations and interviews conducted in the participants' homes. During the three-year follow-up, 53% of Blacks and 29% of Whites lost at least one tooth. Blacks lost 13% of their remaining teeth compared with 4% for Whites. Logistic regression models showed that factors related to tooth loss for Blacks were: more S. mutans in stimulated saliva, deeper periodontal pockets, more P. intermedia in subgingival plaque, high blood pressure, limited help from others, and few symptoms of depression. For Whites, significant factors were: more lactobacilli in stimulated saliva, history of current oral pain at baseline, more alcohol consumption, no history of past use of calcium or xerostomic medications, higher income, lower occupational prestige, and increased numbers of negative life events. This study showed that older Blacks were at greater risk of tooth loss than older Whites. For both races, factors such as oral bacteria, periodontal conditions, oral symptoms, and psychosocial and economic factors are related to increased risk of tooth loss.

Black or African American↗
PubMed1995

Eighteen-month incidence of tooth loss among older adults in North Carolina.

This study investigated tooth loss in North Carolina adults 65 years of age or older. A random sample of 335 Blacks and 284 Whites participated in dental examinations and interviews at baseline and again after 18 months. Blacks were more likely than Whites to lose at least one tooth (36% vs 19%), and they lost more teeth on average (1.0 vs 0.4). Several oral disease conditions and symptoms were related to tooth loss, but many other hypothesized factors were not. Risk models were inconclusive in the identification of factors related to risk of tooth loss.

Aged↗
PubMed1994

Eighteen-month coronal caries incidence in North Carolina older adults.

In this longitudinal study of a random sample of North Carolinians over the age of 65 and living in their homes, 325 blacks and 280 whites were examined and interviewed 18 months after baseline examinations. Coronal caries incidence was greater among whites than blacks. The increment due to teeth becoming root fragments were similar for both races; however, there were more newly crowned teeth among whites. Newly crowned surfaces were not used as part of the caries increment in logistic regression models to investigate potential risk predictors. For blacks, caries development over the 18-month period was associated with a higher lactobacillus score and more coronal caries at baseline, more previously filled coronal surfaces, and lack of active membership in clubs or other groups. For whites, having no self-reported tooth sensitivity, having a lower socioeconomic index score, taking antihistamine medications at baseline, and having the perception of more problems after the age of 40 than before were all associated with the development of coronal caries.

Black or African American↗
PubMed1994

Effects of acetylpromazine, xylazine, and vertical load on digital arterial blood flow in horses.

Palmar digital arterial blood flow was measured in 6 conscious, standing horses, using surgically placed perivascular ultrasonic flow probes. The effects of 2 dosages of xylazine (0.55 and 1.1 mg/kg of body weight) and of 3 dosages of acetylpromazine (0.01, 0.02, and 0.04 mg/kg), as well as the effect of vertical load, on digital blood flow were evaluated. Intravenous administration of xylazine induced a significant (P < 0.05), transient decrease in digital blood flow. Intravenous administration of acetylpromazine induced a significant (P < 0.05), prolonged increase in digital blood flow. Correlation between vertical load and digital blood flow was found. The results of this study indicate that use of acetylpromazine may be beneficial in clinical treatment of horses with reduced digital blood flow. Xylazine, on the other hand, may exacerbate ischemic conditions of the digit and should be used with caution.

Acepromazine↗
PubMed1993

A retrospective evaluation of laminitis in horses.

Case records of 202 horses treated for laminitis were reviewed with the intent of determining the long-term outcome and correlating this with digital radiographic findings and with the degree of pain associated with the laminitis. At long-term follow-up 57 horses had returned to athletic soundness (Group 1), 20 horses were intermittently lame (Group 2), 19 horses had permanent severe lameness (Group 3), 97 were dead (Group 4), and 9 were lost to follow up. Using simple regression analysis, functional outcome did not correlate with the degree of rotation (R2 = 0.004) or the presence of distal displacement (R2 = 0.139). Functional outcome did correlate with the clinical grade of laminitis (R2 = 0.504). Horses in Group 1 had significantly less distal phalangeal rotation (5.89 +/- 6.48 degrees) than did horses in Group 2 (11.10 +/- 8.19) and Group 3 (14.50 +/- 10.80), but were not significantly different from Group 4 horses (7.49 +/- 6.57). Of 96 surviving horses, 23 had evidence of distal displacement compared with 54 of 97 non-survivors. Based on these results, horses that develop distal displacement of the distal phalanx are more likely to die than are horses without distal displacement; however, the presence or absence of distal phalangeal displacement and the degree of distal phalangeal rotation cannot be used to predict the outcome of a horse with laminitis. Clinical assessment is a more reliable means of determining the final outcome and should be given precedence over radiographic findings.

Animals↗